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The association of Chinese hospital work environment with nurse burnout, job satisfaction, and intention to leave
Open accessAbstract
The purpose of this study was to describe nurse burnout, job satisfaction, and intention to leave and to explore the relationship of work environment to nursing outcomes in a sample of 9,698 nurses from 181 hospitals in China. Nurses reported moderate levels of emotional exhaustion and depersonalization and high levels of reduced personal accomplishment. Nearly one-fifth of the nurses reported high levels of burnout on all three dimensions. Forty-five percent of the nurses were dissatisfied with their current job; these nurses were most dissatisfied with their salary. Five percent of nurses reported an intention to leave. Nurses reporting mixed and good work environments were less likely to report high burnout, job dissatisfaction, and intention to leave compared with those in poor work environments. The results suggest that high burnout and low job satisfaction are prominent problems for Chinese nurses, and improving work environment might be an effective strategy for better nursing outcomes in Chinese hospitals.
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“only one study concluded there is an association between work environment and all MBI dimensions [95]”
From Burnout in nursing: a theoretical review. (2020) · cites this paper as [95]
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Citations
Cites
Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction
Aiken, L. H. (2002) · JAMA · doi:10.1001/jama.288.16.1987 · Cited by 5,226
Champion, D. F., & Westbrook, B. W. (1984) · Measurement and Evaluation in Counseling and Development · doi:10.1080/07481756.1984.12022754 · Cited by 2,389
Maslach, C., & Jackson, S. E. (1979) · PsycTESTS Dataset · doi:10.1037/t55656-000 · Cited by 2,360
Development of the practice environment scale of the nursing work index†‡
Lake, E. T. (2002) · Research in Nursing & Health · doi:10.1002/nur.10032 · Cited by 1,769 · cited 1×
“Higher scores indicate agreement that the item is present in the environment, which means a better work environment, and the mean subscale scores are derived by averaging item means for each subscale (Lake, 2002).”
MethodNurses’ Reports On Hospital Care In Five Countries
Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J. A., Busse, R., Clarke, H. F., Giovannetti, P., Hunt, J., Rafferty, A. M., & Shamian, J. (2001) · Health Affairs · doi:10.1377/hlthaff.20.3.43 · Cited by 1,623 · cited 2×
“In this study, 5.1% of nurses expressed an intention to leave their present job in the next 12 months, which was much lower than the findings in Western countries (Aiken et al., 2001) although contract nurses were more likely to report an intention to leave compared with bianzhi nurses.”
BackgroundResultInfluentialEffects of Hospital Care Environment on Patient Mortality and Nurse Outcomes
Aiken, L. H., Clarke, S. P., Sloane, D. M., Lake, E. T., & Cheney, T. (2008) · JONA: The Journal of Nursing Administration · doi:10.1097/01.nna.0000312773.42352.d7 · Cited by 860 · cited 3×
“Following the aggregation method used in similar studies (Aiken et al., 2008; Liu et al., 2012; Nantsupawat et al., 2011), we analyzed the work environment at the hospital level.”
BackgroundMethodEffects of Hospital Care Environment on Patient Mortality and Nurse Outcomes
Aiken, L. H., Clarke, S. P., Sloane, D. M., Lake, E. T., & Cheney, T. (2009) · JONA The Journal of Nursing Administration · doi:10.1097/nna.0b013e3181aeb4cf · Cited by 799
McHugh, M. D., Kutney-Lee, A. M., Cimiotti, J. P., Sloane, D. M., & Aiken, L. H. (2011) · Health Affairs · doi:10.1377/hlthaff.2010.0100 · Cited by 772 · cited 1×
“…with salary and benefits, more than one half of the nurses reported dissatisfaction with their professional status, which was much higher than the reports in the United States, where only 17% of bedside nurses in hospitals indicated dissatisfaction with professional status (McHugh et al., 2011).”
ResultNurse burnout and quality of care: Cross‐national investigation in six countries
Poghosyan, L., Clarke, S. P., Finlayson, M., & Aiken, L. H. (2010) · Research in Nursing & Health · doi:10.1002/nur.20383 · Cited by 574
Importance of work environments on hospital outcomes in nine countries
Aiken, L. H., Sloane, D. M., Clarke, S. P., Poghosyan, L., Cho, E., You, L., Finlayson, C. M., Kanai‐Pak, M., & Aungsuroch, Y. (2011) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzr022 · Cited by 465 · cited 16×
“In this study, work environment was positively related to nursing outcomes, which is consistent with the studies in other countries (Aiken et al., 2011; Van Bogaert et al., 2010).”
BackgroundResultInfluentialSelf-citation
Research works printed but not linked: 2
- Gu, 2011, The human resource crisis in the field of Chinese medicine (in Chinese), Journal of China National School of Administration, 6, 17
- Xun, 2011, A Study on the nurse work environment and intention to leave (in Chinese), Chinese Journal of Practical Nursing, 27, 64
Cited by
Sorted by citations
Items 201–228 of 228
Vieira, M. V. (2015) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.22.2015.tde-27072015-164051
Analysing Nursing Workload in Intensive Care Unit by Using a Novel Objective Tracking System
Guo, P. (2015) · UC Research Repository (University of Canterbury) · doi:10.26021/2784
Meta-Analysis of Evidence from the Practice Environment Scale of the Nursing Work Index
Sanders, J. (2015) · ScholarlyCommons (University of Pennsylvania)
The Nursing Practice Environment and Job Outcomes in Saudi Hospitals
Ambani, Z. (2017) · ScholarlyCommons (University of Pennsylvania)
Stress and Burnout among Preretirement Employee in Hospital at 10th of Ramadan City
Allah, E. S. A., Hussein, S. S. H., Farg, H. K., & Ibrahim, M. E. (2019) · Communication Society and Media · doi:10.22158/csm.v2n1p41
Critical Care Nursing in Hong Kong
So, H. M., & Cao, X. (2018) · Connect The World of Critical Care Nursing · doi:10.1891/1748-6254.12.3.70
“The heavy workload and the stressful experiences affect nurses’ health and may increase their intention to leave ICU (Toh, Ang, & Devi, 2012; Zhang et al., 2014).”
BackgroundHospital nurses' attitudes to work: a case study of a Chinese hospital
Feng, F. (2018) · Wolverhampton Intellectual Repository and E-Theses (University of Wolverhampton)
Steponkus, T., Ustinavičienė, R., & Urbonas, G. (2019) · Health Sciences · doi:10.35988/sm-hs.2019.060
간호사의 간호업무성과 예측모형: 긍정심리자본을 중심으로
이, 순., & 김, 정. (2020) · Journal of Korean Academy of Nursing
Factors Influencing Nurse Turnover in Selected Hospitals in Kabul, Afghanistan
Haidari, N., Sahoo, T., Faizi, N., & Paigham, A. M. (2020) · Indian Journal of Nursing Sciences · doi:10.31690/ijns.2020.v05i03.003
“This result aligns with findings from the previous studies,[6,7,31] and it may be explained by the fact that older nurses are more likely to think about retirement than about leaving, and job stability is more important for them.”
BackgroundResultInfluentialFactors affecting occupational burnout in nurses working in a medical oncology clinic
Eraslan, P., & İlhan, A. (2021) · Journal of Health Sciences and Medicine · doi:10.32322/jhsm.944258
Zhu, S., Hu, J., Gruber, K. J., Li, G., Li, L., & Ke, Y. (2021) · Journal of Nursing Education and Practice · doi:10.5430/jnep.v12n2p72
“[27] An additional explanation of these findings is that negative attitudes might have been shaped by lack of knowledge about the roles of nursing.[43] Moreover, findings of our study found there was a positive relationship between knowledge, attitude and intention.”
BackgroundGorah, R. N. M., & Mukhtar, M. (2021) · Basic and Applied Nursing Research Journal · doi:10.11594/banrj.02.01.01
“The discoveries additionally feature the relationship of a steady workplace to medical attendant occupation outcomes [18].”
BackgroundHemodialysis nurse burnout from 31 provinces in mainland China: a cross-sectional survey (Preprint)Preprint
Zhou, L., Guo, W., Song, L., Zhang, G., Zhong, M., Sun, C.-Y., Mo, Y.-W., Zheng, S., Chen, Y.-G., Liang, X., et al. (2020) · doi:10.2196/preprints.20125
Prevalence of Psychosocial Problems among Female Employees (A Study in Aligarh)
Patric, P. K., Eram, U., Khalique, N., & Ahmad, A. (2022) · Scholars International Journal of Traditional and Complementary Medicine · doi:10.36348/sijtcm.2022.v05i08.002
“Another study [12] also reported that about 20% of the nurses were found to have high levels of all three dimensions of burnout Study [13] also contradicts this finding where most of the nurses (70.5”
ResultInfluentialİşyeri Yalnızlığı ve İşten Ayrılma Niyetine Etkisi: Kamu Kurumları Örneklemi
TorunoğullarI, M., & Tunçay, S. S. (2023) · Akademisyen Kitabevi eBooks · doi:10.37609/akya.2857
Mesele, T. T., Chernet, S. A., Aragaw, G. M., & Asaye, M. M. (2025) · Eleutho · doi:10.18332/eleutho/201474
Martínez, M., Cánovas, C. P., Leal‐Costa, C., Ferrer, M. B. C., Agea, J. L. D., & Jiménez‐Ruiz, I. (2025) · Anales del Sistema Sanitario de Navarra · doi:10.23938/assn.1111
The Relationship Between Nurses' Evaluation of Working Environments and Tendency to Medical Error
Kızılkeçi, C. V., & Er, F. (2025) · Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırmaları Dergisi · doi:10.46413/boneyusbad.1494699
Factors Affecting to Employee Intention to Leave the Job in Nepalese Commercial Banks
Sony, S. K., & Sah, P. (2025) · Nepalese journal of economics. · doi:10.3126/nje.v9i1.80389
Asignación del personal de enfermería vs. indicadores hospitalarios: revisión paraguas
Parra, D. I., Salazar, J. K. P., Arenas, L. A. E., & Garzón, N. E. (2024) · Avances en Enfermería · doi:10.15446/av.enferm.v42n3.114392
Jang, D., Yan, C., Won, J., Lee, S., & Fang, L. (2025) · International Journal of Sport and Exercise Psychology · doi:10.1080/1612197x.2025.2563316 · Cited by 1
Cheng, W., Tu, J., & Shen, X. (2021) · Figshare · doi:10.6084/m9.figshare.14773807
Djediat, A. (2018) · theses.fr (ABES) · doi:10.70675/7d7b962az5fd2z4bfcz93b4za1ced13503df
Yan, D., Zhou, Y., Chang, J., Zhang, Y., & Chen, L. (2026) · BMC Nursing · doi:10.1186/s12912-026-05023-x
“This situation may lead nurses to feel depressed and stressed, and even doubt their career choices [42].”
Ma, H., Dong, J., Li, Y., Leong, Q. N., Teng, X. J., Yuan, L., Tao, M., & Jiang, Y. (2026) · BMC Nursing · doi:10.1186/s12912-026-05031-x
“The weight of these duties, combined with a demanding hospital work environment, contributes to high levels of burnout among nurses across countries [54, 63].”
Emergency Service/Department as an (Un)Favorable Nursing Practice Environment
Alves, T. S. P., Cardoso, A. P. S., Alvarelhão, J., & Sardo, P. M. G. (2026) · Journal of Emergency Nursing · doi:10.1016/j.jen.2026.06.015 · Cited by 1
Metadata
- Authors
- Zhang, L.-F., You, L.-M., Liu, K., Zheng, J., Fang, J.-B., Lu, M.-M., Lv, A.-L., Ma, W.-G., Wang, J., Wang, S.-H., Wu, X., Zhu, X.-W., & Bu, X.-Q.
- Affiliations
- Sun Yat-sen University (CN)
- China Medical University (CN)
- Peking University (CN)
- Venue
- Nursing Outlook
- Publisher
- Elsevier BV
- Published
- 2014-03
- Volume
- 62
- Issue
- 2
- Pages
- 128-137
- ISSN
- 0029-6554 (ISSN-L)
- PMC
- PMC3959248
- OpenAlex
- W2086028708
- Cited by
- 228
- References
- 35
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 11 · 2023: 15 · 2022: 17 · 2021: 34 · 2020: 31 · 2019: 29 · 2018: 18 · 2017: 20 · 2016: 13 · 2015: 17 · 2014: 4
- FWCI
- 33.42
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Nursing Outlook (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- China Medical Board (R01NR004513)
- European Commission
- National Institute of Nursing Research (R01NR004513)
- Topics
- Health Sciences › Nursing › Research and Theory › Nursing education and management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Burnout
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Keywords
- nurse burnout, job satisfaction, turnover intention, work environment, emotional exhaustion, depersonalization, personal accomplishment, salary dissatisfaction, Chinese nurses, hospital nursing workforce
- MeSH terms
- Adolescent, Adult, Burnout, Professional, China, Female, Humans, Job Satisfaction, Male, Middle Aged, Nursing Staff, Hospital, Personnel Turnover, Retrospective Studies, Salaries and Fringe Benefits, Stress, Psychological, Workplace, Young Adult
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